Benard Beall, United States of America

Centres for Disease Control and Preventio Bacterial diseases

Author Of 2 Presentations

 Conference Calendar

HIGH CARRIAGE PREVALENCE OF ANTIMICROBIAL-NON-SUSCEPTIBLE PNEUMOCOCCI IN CHILDREN WITH RADIOLOGICALLY CONFIRMED PNEUMONIA THREE YEARS AFTER 10-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV10) INTRODUCTION IN MOZAMBIQUE (ID 996)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement
Presenter
Authors

Abstract

Background

Antimicrobial resistance (AR) is a global problem, and drug-resistant pneumococci are a serious AR threat. We evaluated carriage of antimicrobial non-susceptible pneumococci in children with X-ray confirmed pneumonia (XRCP) 3 years after PCV10 introduction in Mozambique.

Methods

We collected nasopharyngeal swabs from children who were age-eligible for PCV and hospitalized with XRCP at 3 hospitals (2 urban, 1 rural) in southern Mozambique between October 2015-May 2016. Specimens were cultured for pneumococci; isolates underwent serotyping by Quellung and antimicrobial susceptibility testing using broth microdilution. Non-susceptible isolates had intermediate or full resistance based on CLSI 2018 breakpoints; multi-drug non-susceptible (MDNS) isolates were non-susceptible to ≥3 antimicrobial classes.

Results

Pneumococci were detected in 90 (42.1%) of 214 children with XRCP. Of those, 28.9% (26/90) and 81.1% (73/90) carried PCV10-type and penicillin-non-susceptible pneumococci, respectively. Among 29 (32%) children colonized with MDNS-pneumococci, serotypes 23F (27.6% [n=8]) and 19F (17.2% [n=5]) were most prevalent. PCV10-types were more associated with penicillin-non-susceptibility (100% vs. 73.4%, P=0.002) and MDNS (69.7% vs. 17.2%, P<.001) than non-PCV10-types. Non-susceptibility to 3rd generation cephalosporins was found in two 19F isolates.

Conclusions

High prevalence of penicillin-non-susceptible and MDNS-vaccine-type pneumococcal carriage among children with pneumonia post-PCV10 introduction in Mozambique is concerning and suggests new prevention strategies are needed.

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PREVALENCE OF VACCINE-TYPE PNEUMOCOCCAL CARRIAGE FIVE YEARS AFTER 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) INTRODUCTION IN GHANA (ID 663)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement
Presenter
Authors

Abstract

Background

Outbreaks of vaccine-type (VT) pneumococcal meningitis, especially serotype 1 (ST1), continue in Ghana despite PCV13 introduction in 2012 (6, 10, and 14-week schedule) and coverage >85%. We assessed VT-pneumococcal carriage prevalence, focusing on ST1, during the 2018 meningitis season

Methods

We conducted a cross-sectional nasopharyngeal (NP) carriage survey from February-July in three northern Ghana “meningitis belt” regions. Individuals aged 6 weeks-35 years with respiratory symptoms or clinical signs of meningitis were recruited from emergency departments across 6 hospitals. Pneumococci isolated from NP swabs were serotyped by Quellung; ST1 isolates were sequenced.

Results

Among 934 participants, 671 (71.8%) carried pneumococci. Overall and VT-pneumococcal carriage were 76.3% (464/608) and 21.5% (131/608) in <5 years, 67.4% (116/172) and 26.7% (46/172) in 5-14 years, and 59.1% (91/154) and 19.5% (30/154) in 15-35 years, respectively. ST1 colonization was lower in participants <5 versus ≥ 5 years-old (0.3% [2/608] vs. 3.1% [10/326]; P=0.001). All ST1 isolates were sequence type 217/303, but not closely related. Serotypes 3, 19F, 23F, 6A and 14 were the most prevalent PCV13-types.

Conclusions

VT-pneumococcal carriage remains common in Ghana, with ST1 colonization more common among those too old to have received PCV13. Vaccination strategies to decrease VT-pneumococcal transmission are needed.

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